1. Field of the Invention
The present invention relates to apparatus and method for performing circular end-to-end compression anastomoses and more particularly, to apparatus and method for performing compression anastomoses endoscopically.
2. Description of the Related Art
Performing anastomoses to connect tissue within the body is well-known in the art. For example, circular end-to-end anastomoses are commonly performed to join together the ends of hollow organs such as the intestines. Typically, a diseased or blocked portion of the intestine is cut-out and the healthy ends joined together. One method of performing anastomoses involves the use of compression members which compress the ends of the hollow sections to be joined together, thereby allowing a natural anastomosis to occur in the tissue adjacent the compressed tissue. After a period of time, due to necrosis of the compressed edges, the compression devices fall inside the intestine and are then evacuated therefrom during normal excretion of waste. Compression anastomoses have typically been performed by gaining access to the surgical site either rectally or through open surgery. In the case of the rectally performed procedures, anastomosis is limited to the most distal tracts of the intestine. In the case of open surgery to place compression members, the patient's recovery is lengthened due to the extensive healing required of the incisions made to access the surgical site.
Another method of performing anastomoses involves the use of a circular stapling device which applies an annular array of staples to join the ends of hollow organs. A common procedural step of forming an anastomosis, either using a circular stapler or with other known methods and apparatus, is to apply a "purse string" suture to each of the ends to be anastomosed. The "purse string" suture is utilized to draw the ends of the hollow organ closed so that, inter alia, a complete anastomosis is formed when the ends of the organ are joined either by compression devices or by a surgical stapling device.
In laparoscopic procedures, surgery is performed in the interior of the abdomen through small incisions; in endoscopic procedures, surgery is performed in any hollow viscus of the body through narrow endoscopic tubes inserted through natural orifices. Laparoscopic procedures generally require that any instrumentation inserted into the body be sealed, i.e. provisions must be made to ensure that gases do not enter or exit the body through the laparoscopic incision or instruments as, for example, in surgical procedures in which the surgical region is insufflated. Moreover, laparoscopic and endoscopic procedures often require the surgeon to act on organs, tissues and vessels deep within the body, thereby requiring that any instruments be used in such procedures be long and narrow while being functionally controllable from the end of the instrument outside the patient's body, i.e. the proximal end. Typically, in laparoscopic and endoscopic procedures, patient recovery time is several days or weeks shorter than that for conventional invasive surgical procedures.
A need presently exists for apparatus and methods which facilitate performing anastomoses through small incisions using compression anastomosis devices which fit through cannulas of lesser diameter than the hollow organ to be anastomosed. That is, a need presently exists for apparatus and methods capable of performing compressional anastomoses endoscopically or laparoscopically so as to both increase the versatility of the procedure and reduce patient recovery time.
An additional need exists for alternative apparatus and method which will perform the function performed by "purse stringing" the ends of hollow organs to be anastomosed.